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BACKWATER PREVENTION DEVICE PROGRAM <br />Our records mdicate Ihat a backwater prevention device must be installed on your <br />sewer connection to comply v.�ith the new ordinance. Please help us verify that our <br />iniormation is correct by ansvlering the /ollrnving questions a6oul your property: <br />Do you have a basemenl? Yes � No ❑ <br />If ves, does it have plumbing fxtures (sink, toilet, floor drain, eta)7 Yes� No ❑ <br />Do you have a backwater valve on your sewer line7 Yes ❑ No ❑ Don't Knotiv�] <br />Do you have a grinder pump in your basement7 Yes ❑ No ❑ Don't Know � <br />Name: l-t \ �PP� _ �� � "' <br />Property address: 1 Zl <br />Phone 1 C�,'��_=,�_L�- �7 j� Phone 2' <br />Email: , fi-�ttl[Y-��'7 fiv� G� � <br />,6�.�:K�w,.i.J�..1.... � _�.�IEJii���.!. ... ..:J..:I.,a <br />